William Harvey Research Institute and Barts and The London, School of Medicine and Dentistry Queen Mary University of London, London, United Kingdom.
Institute of Neurology, University of Catanzaro "Magna Graecia", Catanzaro, Italy.
Curr Med Chem. 2018;25(26):3096-3104. doi: 10.2174/0929867324666170523144402.
In the last years, an increasing interest in molecular imaging has been raised by the extending potential of positron emission tomography [PET]. The role of PET imaging, originally confined to the oncology setting, is continuously extending thanks to the development of novel radiopharmaceutical and to the implementation of hybrid imaging techniques, where PET scans are combined with computed tomography [CT] or magnetic resonance imaging[MRI] in order to improve spatial resolution. Early preclinical studies suggested that 18F-FDG PET can detect neuroinflammation; new developing radiopharmaceuticals targeting more specifically inflammation-related molecules are moving in this direction. Neurological involvement is a distinct feature of various systemic autoimmune diseases, i.e. Systemic Lupus Erythematosus [SLE] or Behcet's disease [BD]. Although MRI is largely considered the gold-standard imaging technique for the detection of Central Nervous System [CNS] involvement in these disorders. Several patients complain of neuropsychiatric symptoms [headache, epilepsy, anxiety or depression] in the absence of any significant MRI finding; in such patients the diagnosis relies mainly on clinical examination and often the role of the disease process versus iatrogenic or reactive forms is doubtful. The aim of this review is to explore the state-of-the-art for the role of PET imaging in CNS involvement in systemic rheumatic diseases. In addition, we explore the potential role of emerging radiopharmaceutical and their possible application in aiding the diagnosis of CNS involvement in systemic autoimmune diseases.
在过去的几年中，正电子发射断层扫描[PET]的扩展潜力引起了人们对分子成像越来越大的兴趣。由于新型放射性药物的发展以及将 PET 扫描与计算机断层扫描[CT]或磁共振成像[MRI]相结合以提高空间分辨率的混合成像技术的实施，PET 成像的作用不断扩大。最初仅限于肿瘤学领域的作用。早期的临床前研究表明，18F-FDG PET 可以检测神经炎症；新开发的针对炎症相关分子的放射性药物正在朝着这个方向发展。神经系统受累是各种系统性自身免疫疾病的一个显著特征，例如红斑狼疮[系统性红斑狼疮]或贝切特病[BD]。尽管 MRI 被广泛认为是检测这些疾病中枢神经系统[CNS]受累的金标准成像技术。一些患者在没有任何明显 MRI 发现的情况下出现神经精神症状[头痛、癫痫、焦虑或抑郁]；在这些患者中，诊断主要依赖于临床检查，而且疾病过程与医源性或反应性形式之间的关系往往存在疑问。本综述的目的是探讨 PET 成像在系统性风湿性疾病中枢神经系统受累中的作用的最新进展。此外，我们还探讨了新兴放射性药物的潜在作用及其在辅助诊断系统性自身免疫性疾病中枢神经系统受累中的可能应用。
